Hearing the word “prolapse” can feel a bit scary. You might worry or feel unsure about what it means for your body and your future. But before you dive into a rabbit hole of worry, take a deep breath. You are absolutely not alone. In fact, about half of all women who have had a baby will experience some degree of pelvic organ prolapse (POP). To learn more about the prevalence and types of prolapse, you can visit the Continence Foundation of Australia.
The best part? It’s highly manageable. This guide will walk you through everything you need to know about pelvic prolapse, from what’s actually going on down there to the steps you can take to regain control and feel like yourself again.
So, What Exactly is Pelvic Organ Prolapse (POP)?
Imagine your pelvic floor muscles as a strong, supportive hammock, stretching from your pubic bone at the front to your tailbone at the back. This hammock’s job is to keep your pelvic organs—your bladder, uterus, and bowel—snug and securely in place. (And it’s not just a ‘women’s issue’—pelvic floor health is important for blokes too!)
Pelvic organ prolapse occurs when this “hammock” of muscles and tissues stretches, weakens, or sustains damage. As a result, one or more of your pelvic organs can start to sag or bulge down into your vagina.
Sometimes, a prolapse can be so mild you don’t even notice it. Other times, it can be more severe, causing discomfort and affecting how your body functions.
The Different Types of Prolapse
A prolapse is named after the organ that has shifted. You can also experience more than one type of prolapse at the same time.
- Cystocele (Bladder Prolapse): The most common type, where the bladder bulges into the front wall of the vagina.
- Rectocele (Rectum/Bowel Prolapse): The rectum pushes into the back wall of the vagina.
- Uterine Prolapse: The uterus slips down into the vaginal canal.
- Urethrocele: The urethra (the tube you wee from) presses into the vagina.
- Enterocele: The small intestine pushes down on the top of the vagina.
What to Look Out For: Common Signs of Prolapse
Symptoms vary greatly depending on the type and severity of your prolapse. Many women describe it as a “bulge,” a feeling of “heaviness,” or like “something is falling out.”
Key signs include:
Physical Sensations:
- A feeling of heaviness, dragging, or pressure in your vagina or pelvis.
- A lump or bulge you can feel or see at the vaginal opening.
- A nagging lower back ache that feels better when you lie down.
Bladder and Bowel Issues:
- Leaking urine when you cough, sneeze, laugh, or exercise.
- A sudden, urgent, or frequent need to urinate.
- Trouble starting urination, or feeling like you can’t fully empty your bladder.
- Constipation, or feeling like you need to press on the vaginal wall to help empty your bowels.
Other Clues:
- Sex can feel uncomfortable or painful.
- Symptoms often feel worse at the end of the day or after you’ve been on your feet for a while.
So, How Does Prolapse Happen? The Main Culprits
Prolapse typically results from too much pressure on the pelvic floor over time. The main risk factors are:
- Pregnancy and Childbirth: Growing and birthing a baby puts your body through significant strain. A vaginal delivery is the biggest contributing factor to pelvic prolapse. Seeing a Women’s Health Physio during and after pregnancy is a game-changer for preparing and healing your body.
- Menopause: The drop in oestrogen during menopause makes pelvic tissues less elastic and supportive, increasing prolapse risk.
- Chronic Straining: Ongoing constipation, a persistent cough (from smoking or allergies), or regularly lifting heavy things (toddlers, anyone?) all put long-term strain on your pelvic floor.
- High-Impact Exercise: Activities like heavy lifting, running, or high-intensity workouts (such as F45 or CrossFit) without the right core support can worsen a prolapse.
- Genetics: Some individuals are simply born with more stretchy connective tissue (hypermobility), making them more prone to prolapse.
- Previous Pelvic Surgery: Surgeries like a hysterectomy can sometimes weaken the structures that support the pelvis.
“I Think I Have a Prolapse. What Now?”
First things first: don’t panic and please don’t self-diagnose on Google. Discovering you might have a prolapse is just the first step on the path to feeling better. Here’s your game plan:
Step 1: Get a Proper Diagnosis
Guessing will only cause you more stress. Your first port of call is a health professional who can perform a proper assessment, usually involving an internal exam to determine the type and grade of your prolapse. Your go-to people are:
- A Women’s Health or Pelvic Floor Physio
- Your GP
- A Gynaecologist or Urogynaecologist
Step 2: Explore Your Treatment Options
The great news is that surgery is rarely the first or only option for prolapse. In fact, non-surgical treatments are the first choice and work incredibly well for most women.
Your New Best Friend: The Pelvic Floor Physio
This is your absolute gold-standard, first-line treatment for prolapse. A qualified Pelvic Floor Physio will create a program just for you. Did you know that over half of women perform “Kegels” incorrectly? A good physio doesn’t just tell you to “do your Kegels”—they teach you how to activate the right muscles, at the right time, with the right technique.
They will:
- Give you exercises to build strength and endurance in your pelvic “hammock” to better support your organs.
- Teach you how to move and breathe in a way that doesn’t put extra pressure on your pelvic floor. This includes learning “The Knack”—a pre-squeeze of your pelvic floor just before you cough, sneeze, or lift.
Pessaries: A Brilliant Support Tool
A pessary is a small device made of medical-grade silicone that’s inserted into the vagina to help support the prolapsed organs. Think of it like an orthotic for your vagina—or a sports bra for your insides! They come in all shapes and sizes and need to be fitted by a trained health professional. A pessary can provide instant relief from symptoms and make activities like running feel comfortable again while you work on strengthening your muscles affected by prolapse through our exercise rehabilitation classes.
Small Tweaks, Big Wins: Everyday Lifestyle Changes
- Manage Constipation: A high-fibre diet and plenty of water are your best friends to avoid straining on the loo, which can worsen prolapse.
- Lift Smart: Learn the right technique to protect your pelvic floor. A simple trick is to “exhale on the effort” as you lift.
- Tweak Your Workout: Swap high-impact exercise for more gentle options like swimming, cycling, or modified strength training until your pelvic floor is stronger.
Surgical Options
Surgery is usually recommended for severe cases where other treatments haven’t provided enough relief for prolapse. Even if you do need surgery, seeing a pelvic floor physio before and after is essential for achieving the best possible long-term result.
Common Questions (The Stuff You Really Want to Ask)
Q: Will my prolapse just go away on its own?
A: A very mild prolapse after childbirth might improve with a bit of rest, but it won’t fix itself completely without some help. Pelvic floor physio is key to rebuilding strength and preventing it from worsening.
Q: Can I still exercise if I have a prolapse?
A: Absolutely! In fact, the right kind of exercise is fantastic for you. A pelvic floor physio can show you how to modify your favourite activities to keep them safe and effective, so you don’t have up what you love due to prolapse.
Q: Is my prolapse doomed to get worse?
A: Not necessarily! With the right physio guidance and lifestyle tweaks, you can successfully manage your symptoms and prevent the prolapse from progressing.
You’re in the Driver’s Seat of Your Pelvic Health
A prolapse diagnosis isn’t a life sentence of sitting on the sidelines. It’s simply a sign from your body that it needs some targeted care and attention. By understanding what’s going on and choosing proven treatments like pelvic floor physiotherapy, you can manage your symptoms, rebuild your strength, and get on with living a full, active life.
Ready to get started? Our team of women’s health physios are experts at creating personalised programs to get you feeling strong, supported, and back to doing what you love. Book a chat today and let us help you on your way.